Abstract
Children with behavior externalizing disorders are difficult to cope with and might have a negative impact on parent–child interactions and couples relationships, as well as on parents’ psychological adjustment. The present study evaluates the effectiveness of a parent training program [Incredible Years (IY) Basic Program] for improving positive relationships in Portuguese families of preschoolers with symptoms of oppositional/defiant disorder. Eighty-three families randomly assigned to an IY intervention (n = 44) or to a waiting list control group (CG; n = 39) were evaluated, at baseline and 6 months after the intervention, on the following variables: mothers observed positive parenting practices and coaching skills; mothers’ self-reported dysfunctional parenting practices; mothers’ depressive symptoms; perceived couples intimacy; and children’s behavior. Moreover, families who had received the IY program were also assessed in the same variables 12-months after baseline. Observed and self-reported positive parenting practices, couples openness to exterior and children’s oppositional behavior improved significantly more from pre- to post-assessment in the intervention group (IG) than in the CG (medium to large effect sizes). Changes observed in the IG were sustained at the 12-month follow-up. However, the improvements in coaching skills that had been observed at the 6 months follow-up in the IG decreased over time. The findings indicate that the IY Parent Program is a promising intervention to promote more positive parent–child relationships, decrease children’s oppositional behaviors and develop couple’s willingness to open to the exterior, from the mother’s point of view.
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Abreu-Lima, I., Alarcão, M., Almeida, A., Brandão, T., Cruz, O., Gaspar, M.et al. (2010). Avaliação de intervenções de educação parental: Relatório [Assessment of parental education interventions: Report]. Retrieved from http://www.cnpcjr.pt/preview_documentos.asp?r=3493&m=PDF.
Almeida, L. (1998). O raciocínio diferencial dos jovens portugueses: Avaliação, desenvolvimento e diferenciação [Differential reasoning in Portuguese youth: Assessment, development and differentiation]. Porto: Instituto Nacional de Investigação Científica.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Arnold, D., O’Leary, S., Wolff, L., & Acker, M. (1993). The Parenting Scale: A measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5, 137–144.
Azevedo, A., Seabra-Santos, M. J., Gaspar, M. F., & Homem, T. (2013a). The incredible years basic parent training for Portuguese preschoolers with AD/HD behaviors: Does it make a difference? Child & Youth Care Forum. doi:10.1007/s10566-013-9207-0.
Azevedo, A., Seabra-Santos, M. J., Gaspar, M. F., & Homem, T. (2013b). A parent-based intervention program involving preschoolers with AD/HD behaviors: Are children’s and mothers’ effects sustained over time? European Child and Adolescent Psychiatry. doi:10.1007/s00787-013-0470-2.
Baker, B., & Heller, T. (1996). Preschool children with externalizing behaviors: Experience of fathers and mothers. Journal of Abnormal Child Psychology, 24, 513–532.
Beck, A., Ward, C., Mendelson, M., Mock, J., & Erbaugh, G. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 53–63.
Belsky, J. (1984). The determinants of parenting: A process model. Child Development, 55, 83–96.
Bloomquist, M., & Schnell, S. (2002). Helping children with aggression and conduct problems: Best practices for intervention. London: Guilford Press.
Bywater, T., Hutchings, J., Daley, D., Whitaker, C., Yeo, S., Jones, K., et al. (2009). Long-term effectiveness of a parenting intervention in Sure Start services in wales for children at risk of developing conduct disorder. British Journal of Psychiatry, 195, 318–324. doi:10.1192/bjp.bp.108.056531.
Cabral, A., Ferreira, A., Santos, J., Gaspar, M., Silva, P., & Eufrazia, R. (2009/2010). Uma aventura no mundo da família [An adventure in the world of the family]. Gouveia: Edições GAF.
Campbell, S. (1995). Behavior problems in preschool children: A review of recent research. Journal of Child Psychology and Psychiatry, 36, 113–149. doi:10.1111/j.1469-7610.1995.tb01657.x.
Campbell, S., Shaw, D., & Gilliom, M. (2000). Externalizing behavior problems: Toddlers and preschoolers at risk for later maladjustment. Development and Psychopathology, 12, 467–488. doi:10.1017/S0954579400003114.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Laurence Erlbaum.
Cummings, E., Davies, P., & Campbell, S. (2000). Developmental psychopathology and family process. New York: Guilford Press.
Dadds, M., Schwartz, S., & Sanders, M. (1987). Marital discord and treatment outcome in behavioral treatment of child conduct disorders. Journal of Consulting and Clinical Psychology, 55, 396–403. doi:10.1037/0022-006X.55.3.396.
Fleitlich, B., Loureiro, M., Fonseca, A., & Gaspar, F. (2005). Questionário de capacidades e dificuldades (SDQ-Por) [Strenghts and difficulties questionnaire, Portuguese version]. www.sdqinfo.org.
Fossum, S., Handegard, B. H., Martinussen, M., & Morch, W. T. (2008). Psychosocial interventions for disruptive and aggressive behaviour in children and adolescents: A meta-analysis. European Child and Adolescent Psychiatry, 17, 438–451.
Gardner, F. (1994). The quality of joint activity between mothers and their children with conduct problems. Journal of Child Psychology and Psychiatry, 35, 935–949. doi:10.1111/j.1469-7610.1994.tb02303.x.
Gardner, F., Burton, J., & Klimes, I. (2006). Randomised controlled trial of a parenting intervention in the voluntary sector for reducing child conduct problems: Outcomes and mechanisms of change. Journal of Child Psychology and Psychiatry, 47(11), 1123–1132. doi:10.1111/j.1469-7610.2006.01668.x.
Gardner, F., Shaw, D., Dishion, T., Supplee, L., & Burton, J. (2007). Randomized prevention trial for early conduct problems: Effects on proactive parenting and links to toddler disruptive behavior. Journal of Family Psychology, 21, 398–406. doi:10.1037/0893-3200.21.3.398.
Gaspar, M., & Seabra-Santos, M. (2008). First results from the translation, implementation and researching of the Webster–Stratton “incredible years” basic parenting programme in Portugal. In C. Canali, T. Vecchiato, & J. Whittaker (Eds.), Assessing the “evidence-base” of intervention for vulnerable children and their families (pp. 115–117). Padova: Fondazione Emanuela Zancan onlus.
Gomez, R., & Sanson, A. (1994). Mother–child interactions and noncompliance in hyperactive boys with and without conduct problems. Journal of child psychology and psychiatry, and allied disciplines, 35, 477–490. doi:10.1111/j.1469-7610.1994.tb01735.x.
Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology, Psychiatry and Allied Disciplines, 38, 581–586. doi:10.1111/j.1469-7610.1997.tb01545.x.
Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire (SDQ). Journal of American Academy of Child and Adolescent Psychiatry, 40, 1337–1345. doi:10.1097/00004583-200111000-00015.
Hutchings, J., Bywater, T., Daley, D., Gardner, F., Whitaker, C., & Edwards, R. (2007). Parenting intervention in sure start services for children at risk of developing conduct disorder: Pragmatic randomized controlled trial. British Medical Journal, 334, 678–682. doi:10.1136/bmj.39126.620799.55.
Hutchings, J., Bywater, T., Williams, M., Lane, E., & Whitaker, C. (2012). Improvements in maternal depression as a mediator of child behaviour change. Psychology, 3, 795–801. doi:10.4236/psych.2012.329120.
Jones, K., Daley, D., Hutchings, J., Bywater, T., & Eames, C. (2007). Efficacy of the incredible years basic parent training program as an early intervention for children with conduct problems and ADHD. Child: Care, Health and Development, 33, 749–756. doi:10.1111/j.1365-2214.2007.00747.x.
Katz, L. F., & Gottman, J. M. (1994). Marital conflict styles and children’s emotions. In R. Parke & S. Kellam (Eds.), Exploring family relationships with other social contexts (pp. 49–74). Hillsdale, NJ: Lawrence Erlbaum Press.
Linville, D., Chronister, K., Dishion, T., Todahl, J., Miller, J., Shaw, D., et al. (2010). A longitudinal analysis of parenting practices, couple satisfaction, and child behavior problems. Journal of Marital and Family Therapy, 36, 244–255. doi:10.1111/j.1752-0606.2009.00168.x.
Major, S. (2011). Avaliação de aptidões sociais e problemas de comportamento em idade pré-escolar: Retrato das crianças portuguesas [Assessment of social skills and behavior problems in preschool ages: Portrait of Portuguese children]. Doctoral dissertation. https://estudogeral.sib.uc.pt/bitstream/10316/17774/5/Tese_Sofia%20Major.pdf.
Matos, M., Bauermeister, J., & Bernal, G. (2009). Parent–child interaction therapy for Puerto Rican preschool children with ADHD and behavior problems: A pilot efficacy study. Family Process, 48, 232–252. doi:10.1111/j.1545-5300.2009.01279.x.
McGilloway, S., Mhaille, G., Bywater, T., Furlong, M., Leckey, Y., Kelly, P., et al. (2012). A parenting intervention for childhood behavioral problems: A randomized controlled trial in disadvantaged community-based settings. Journal of Consulting and Clinical Psychology, 80, 116127. doi:10.1037/a0026304.
McMahon, R. (2006). Parent training interventions for preschool-age children. In R. Tremblay, R. Barr & R. Peters (Eds.), Encyclopedia on early childhood development. http://www.excellenceearlychildhood.com/documents/McMahonRJANGxp.pdf.
Menting, A.T., Orobio de Castro, B., & Matthys, W. (2013). Effectiveness of the incredible years parent training to modify disruptive and prosocial child behavior: A meta-analytic review. Clinical Psychology Review, 33, 901–913. doi:10.1016/j.cpr.2013.07.006.
Merrell, K. (2002). Preschool and kindergarten behavior scales (2nd ed.). Austin, TX: PRO-ED.
Moreira, H., Amaral, A., & Canavarro, M. C. (2009). Adaptação do personal assessment of intimacy in relationships scale (PAIR) para a população Portuguesa: Estudo das suas características psicométricas [Adaptation of the Personal assessment of intimacy in realtionships scale (PAIR) for Portuguese population: Study of its psychometric characteristics]. Psychologica, 50, 353–373.
Patterson, G. (2002). The early development of coercive family process. In J. B. Reid, G. R. Patterson, & J. Snyder (Eds.), Antisocial behavior in children and adolescents: A developmental analysis and model for intervention (pp. 25–44). Washington, DC: American Psychological Association.
Patterson, G., DeGarmo, D., & Forgatch, M. (2004). Systematic changes in families following prevention trials. Journal of Abnormal Child Psychology, 32, 621–633. doi:10.1037/a0016732.
Patterson, G., & Sanson, A. (1999). The association of behavioural adjustment to temperament, parenting and family characteristics among five-year-old children. Social Development, 8, 293–309. doi:10.1111/1467-9507.00097.
Perrin, E., Sheldrick, R. McMenamy, J., Henson, B., & Carter, A. (2013). Improving parenting skills for families of young children in pediatric settings: A randomized clinical trial. JAMA Pediatrics, 4. doi:10.1001/jamapediatrics.2013.2919.
Podolski, C., & Nigg, J. (2001). Parent stress and coping in relation to child ADHD severity and associated child disruptive behavior problems. Journal of Clinical Child Psychology, 30, 501–511.
Posthumus, J., Raaijmakers, M., Maassen, G., van Engeland, H., & Matthys, M. (2012). Sustained effects of incredible years as a preventive intervention in preschool children with conduct problems. Journal of Abnormal Child Psychology, 40, 487–500. doi:10.1007/s10802-011-9580-9.
Reid, J., Webster-Stratton, C., & Beauchaine, T. (2001). Parent training in headstart: A comparison of program response among African American, Asian American, Caucasian and Hispanic mothers. Prevention Science, 4, 209–227. doi:10.1023/A:1013618309070.
Rijo, D., Motta, C., Silva, D., & Brazão, N. (2013). A prevalência das perturbações mentais em jovens agressores intervencionados pelo Sistema de Justiça Juvenil Português [The prevalence of mental disorders in young offenders in the Portuguese juvenile justice system]. Paper presented at mental health and juvenile justice seminar, Lisbon.
Robinson, E., & Eyberg, S. (1981). The dyadic parent–child interaction coding system: Standardization and validation. Journal of Consulting and Clinical Psychology, 49, 245–250. doi:10.1037/0022-006X.49.2.245.
Rockhill, C., Collett, B., McClellan, J., & Speltz, M. (2006). Oppositional defiant disorder. In J. Luby (Ed.), Handbook of preschool mental health: Development, disorders and treatment (pp. 80–115). New York: Guilford Press.
Routh, D. (1978). Hyperactivity. In P. Magrab (Ed.), Psychological management of paediatric problems (pp. 3–8). Baltimore, MD: University Park Press.
Sameroff, A. (2009). The transactional model. In A. Sameroff (Ed.), The transactional model of development: How children and contexts shape each other (pp. 3–21). Washington, DC: American Psychological Association.
Sanders, M., Markie-Dadds, C., Tully, L., & Bor, W. (2000). The triple P-positive parenting program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68, 624–640. doi:10.1037/0022-006X.68.4.624.
Sawyer, M., Baghurst, P., Arney, F., Clark, J., Graetz, B., Waites, L., et al. (2005). The mental health of young people in Australia: Child and adolescent component of the national survey of mental health and well-being. Canberra: Australian Data Archive, The Australian National University.
Schaefer, M., & Olson, D. (1981). Assessing intimacy: The PAIR inventory. Journal of Marital and Family Therapy, 7(1), 47–60.
Seabra-Santos, M. J., Gaspar, M. F., Azevedo, A., Homem, T. C., Leitão, S., Pimentel, M., et al. (2013). Protocolo de avaliação no âmbito do Projeto “Prevenção/intervenção precoces em distúrbios de comportamento: Eficácia de programas parentais e escolares (PTDC/PSI-PED/102556/2008)—Versão de Investigação. [Protocol of measures for the evaluation of the “Early prevention/intervention in disruptive behavior disorders”: Efficacy of parents and teachers programs’ project—research version]. http://fpce.uc.pt/anosincriveis/protocolo.doc.
Shaw, D., Keenan, K., & Vondra, J. (1994). Developmental precursors of externalizing behavior: Ages 1 to 3. Developmental Psychology, 30, 355–364. doi:10.1037/0012-1649.30.3.355.
Shaw, D., Owens, E., Giovannelli, J., & Winslow, E. (2001). Infant and toddler pathways leading to early externalizing disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 36–43.
Vaz-Serra, A., & Abreu, J. (1973). Aferição dos quadros clínicos depressivos I: Ensaio de aplicação do ‘Inventário Depressivo de Beck’ a uma amostra portuguesa de doentes deprimidos [Evaluation of clinical depression I: Preliminary use of the ‘Beck Depression Inventory’ with a Portuguese sample of depressed patients]. Coimbra Médica, 20, 623–644.
Wakschlag, L., Briggs-Goawan, M., Carter, A., Hill, C., Danis, B., Keenan, K., et al. (2007). A developmental framework for distinguishing disruptive behavior from normative misbehavior in preschool children. Journal of Child Psychology and Psychiatry, 48, 976–987. doi:10.1111/j.1469-7610.2007.01786.
Webster-Stratton, C. (1990). Enhancing the effectiveness of self-administered videotape parent training for families with conduct-problem children. Journal of Abnormal Child Psychology, 18, 479–492. http://67.199.123.90/library/items/enhancing-the-effectiveness-videotraining_1990.pdf.
Webster-Stratton, C. (2001). The parent and child series: A comprehensive course divided into four programs—Leaders’ guide. Seattle: The Incredible Years.
Webster-Stratton, C. (2011). The incredible years parents, teachers, and children training series: Program content, methods, research and dissemination, 1980–2011. Seattle: The Incredible Years.
Webster-Stratton, C., Gaspar, M., & Seabra-Santos, M. J. (2012). Incredible years parent, teachers and children’s series: Transportability to Portugal of early intervention programs for preventing conduct problems and promoting social and emotional competence. Psychosocial Intervention (Intervención Psicosocial), 21, 157–169. doi:10.5093/in2012a15.
Webster-Stratton, C., & Hammond, M. (1999). Marital conflict management skills, parenting style, and early-onset conduct problems: Processes and pathways. Journal of Child Psychology and Psychiatry, 40, 917–927.
Webster-Stratton, C., & Reid, M. J. (2010). The incredible years parents, teachers, and children training series: A multifaceted treatment approach for young children with conduct problems. In J. Weisz & A. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (2nd ed., pp. 194–210). New York: Guilford.
Webster-Stratton, C., Reid, J., & Beauchaine, T. (2011). Combining parent and child training for young children with ADHD. Journal of Clinical Child and Adolescent Psychology, 40, 191–203. doi:10.1080/15374416.2011.546044.
Acknowledgments
This work was supported by the Foundation for Science and Technology (PhD Grant: SFRH/BD/43562/2008; project research grant: PTDC/PSI-PED/102556/2008, also funded by the program Compete in its component Feder).We are very grateful to all the parents and children that kindly participated in this study; and to our project team (group leaders, evaluators and advisers) for their involvement and constant support.
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The authors declare that they have no conflict of interests with respect to the present paper research.
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Homem, T.C., Gaspar, M.F., Santos, M.J.S. et al. Incredible Years Parent Training: Does it Improve Positive Relationships in Portuguese Families of Preschoolers with Oppositional/Defiant Symptoms?. J Child Fam Stud 24, 1861–1875 (2015). https://doi.org/10.1007/s10826-014-9988-2
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DOI: https://doi.org/10.1007/s10826-014-9988-2